Jill Errera has given birth to eight babies, but only one is her child.

Ashley Moore has two children of her own but has borne twins for a couple in London. She is now pregnant for another couple in New Jersey.

Stephanie Scott had three children when she decided to become a surrogate and carry babies for others.

All three North Texas women came to surrogacy with the same sense of purpose. The money was important, and each was paid thousands of dollars. But like many women who decide to carry someone else’s child, compensation wasn’t their main motivator, they said. They enjoyed having children, and they wanted to help people who couldn’t have children on their own.

Ashley Moore (center) of Rockwall, a surrogate who is currently pregnant for a couple; Jill Errera (left) of Dallas, who has been a surrogate four times; and Stephanie Scott, co-owner of Simple Surrogacy, who has also has been a surrogate.

(David Woo/Staff Photographer)

“Imagine you buy a beautiful gift for someone at Christmas and you can’t wait to give it to them,” Errera said. “It’s like that times a million.”

Surrogacy is hardly new.

But rapid developments in reproductive science have given more and more infertile couples hope of becoming parents to their own biological children. And Dallas — already a medical hub — has found itself as a major center for surrogacy.

As more North Texas women make the decision to become surrogates, a community has developed to provide both them and the intended parents the sort of support that is required during the physically and emotionally complex journey that is carrying someone else’s child.

Parents and surrogates must form an intimate partnership built on trust that is as demanding as any marriage. Anxiety and stress can be great on both sides.

Robert and Kirsten Smith (middle row left) pose with Jill Errera (middle row right), who carried their daughter Merrin (front), 7, as a surrogate mom. The Smiths' older daughter Maya Smith, 12, is at back right.

(Nathan Hunsinger/Staff Photographer)

Kirsten Smith and her husband, Robert, had one daughter when they learned she would be unable to get pregnant again. They wanted a second child and decided surrogacy would be their best option. The Plano couple went to a Dallas surrogacy agency and were matched with a woman who seemed to check off all the boxes. The surrogate was financially and emotionally stable and married with her own children.

But like a blind date that didn’t feel right, Kirsten decided “something didn’t click” when she met the woman.

“And then we were introduced to Jill.”

Jill Errera had a young daughter who was about the same age as the Smiths' 4-year-old girl. And she was an experienced surrogate who had carried twins for another couple.

“It made it more comfortable with us because she had gone through it before,” Kirsten Smith said. “We were a little less worried there might be attachment issues with the child.”

Misunderstood option

Thirty years ago, surrogacy was an extremely rare event that closely followed the development of in vitro fertilization (IVF), in which an egg is fertilized with sperm in a lab and then implanted in a woman’s uterus. Since 1978, when the first baby conceived through IVF was born, surrogacy has become a viable reproductive option, albeit one that continues to raise questions about the nature of conception and motherhood. And there may be no more misunderstood part of surrogacy than the motivation of the women who become surrogates.

“For most people, pregnancy isn’t enjoyable: You do it to get the kid,” said Heather Jacobson, a sociologist at the University of Texas at Arlington. “And lots of people can’t understand why someone would want to be a surrogate.”

Photos from families who had a child carried by a surrogate are displayed on the office walls of Stephanie Scott, co-owner of Simple Surrogacy in Dallas.

(David Woo/Staff Photographer)

In the 1980s, most surrogates used their own eggs, fertilized through artificial insemination — a procedure now called traditional surrogacy. But a surrogate using her own eggs raised the risk of deep attachment to a biological child that the surrogate mother would not want to give up.

In 1986, Mary Elizabeth Whitehead refused to give up custody of the child, resulting in a New Jersey court battle known as the Baby M case. Primary custody was eventually awarded to the intended parents, but Whitehead was permitted visitation rights.

Today, most surrogates carry the biological embryo of the intended parents, a procedure known as gestational surrogacy.

“That led to more women wanting to be surrogates because they had no genetic connection to the child,” said Jacobson, who spent more than five years researching surrogacy for her recently published book, Labor of Love: Gestational Surrogacy and the Work of Making Babies.

Mother of three

In 2003, Stephanie Scott was one of those women interested in becoming a surrogate. She was married, living in Fort Worth and the mother of three children.

“I felt complete. I was married and settled down,” she said. “I was a stay-at-home mom, and I felt it was a good opportunity to help someone else.”

Stephanie Scott, co-owner of Simple Surrogacy

(David Woo/Staff Photographer)

Only 23 at the time, her obstetricians told her she was healthy enough to be both a surrogate and an egg donor. Scott researched surrogacy and found a married couple from Colorado seeking help. Scott would lend her womb for the pregnancy, but otherwise she would be genetically unrelated to the child.

Still, she was unprepared for the emotional test ahead. During pregnancy, she had a sense of isolation and uncertainty.

“I felt very alone during my first surrogacy. I didn't have any support or guidance outside of my own family and my own research,” Scott said.

The birth itself was wrenching. “I cried after she was born,” Scott recalled of the little girl she carried.

When a nurse handed her the infant, Scott kept her eyes closed. She told the baby’s mother to please pick the child up.

“She took her into her arms and started bawling. I was crying. It was very emotional,” Scott said.

That experience led Scott to realize that women who choose to become surrogates need greater support. So in 2004, she joined Simple Surrogacy in Dallas as a co-owner. The agency matches surrogates with couples who want a child. Over the years, it has also become a support community for women who undergo the surrogate experience as she did. Women needed to better understand the demands that being a surrogate makes on their time, emotions and physical health, Scott said.

“There is an incredible amount of information women need to know about this process” before making a responsible and educated decision about whether to become a surrogate, Scott said.

Over the years, agencies like Simple Surrogacy also have become something like self-governing bodies that regulate an otherwise unregulated field.

“There needed to be standards in place, someone looking out for the best interests of the women who sacrificed their bodies, time, emotions, health, and who would guide them to ensure they had the best experience possible,” Scott said.

Like many agencies, Scott’s has standards for selecting potential surrogates.

“We want them to be mentally stable, emotionally stable and to know themselves really well,” Scott said. “And know they’d be able to handle going through the process of carrying someone’s baby and then handing it over. It's not for everybody.”

Since the first gestational surrogate pregnancy in the mid-1980s, the number of such births has grown dramatically. While there is no federal data on the number of children born to a surrogate mother, experts estimate there are at least 1,000 surrogate births a year in the U.S. — most of them gestational.

As more nontraditional couples, including older couples and same-sex spouses, seek to have children, the need for surrogates has spiked, particularly in Texas and California.

There’s a simple reason for that. “You need the doctors, and we have them here in Texas,” Jacobson said.

Not finished being pregnant

Each surrogate’s experience is unique.

Jill Errera of Dallas

(David Woo/Staff Photographer)

Errera didn’t want any more children after the birth of her daughter 11 years ago.

“I just wanted an only child,” she said. But she loved the experience of carrying a baby, “so I knew I wasn’t done being pregnant.”

She answered an ad from a prospective parent represented by Simple Surrogacy. Ten years later, the 45-year-old Dallas woman has delivered three sets of twins and a single baby as a surrogate.

She is now on the staff of Simple Surrogacy, working with intended parents. She also tries to dispel the negative stereotypes surrounding surrogates.

“A lot of times people look at us and think, ‘Oh they’re making quick, easy money.’ It’s absolutely not quick, easy money,” said Errera. “It’s probably the hardest money I’ve ever made. It takes a toll on you. But it’s the most rewarding thing I’ve ever done. The outcome is so special and so much bigger than myself.”

Compensation

In her study, Jacobson found that most surrogates are paid $15,000 to $35,000 for a pregnancy. (The price range is higher now.) Experienced surrogates and those giving birth to multiple babies are often paid on the higher end of the scale. Medical costs are separate and paid for by the couples. Total costs, including legal and fertility clinic fees, typically run over $100,000.

Many surrogates view the money as compensation not for themselves so much as for their families.

“Your family suffers during that time [of pregnancy], and to have that compensation to do something special for your family or put it into savings for your kids for later, it’s a benefit,” she said.

Even if the pregnancy goes smoothly, “you’re not just eating bonbons all day,” Errera said. During her first surrogacy, her daughter was 2 years old. “So I was chasing a toddler around, and I was working full time as a paralegal.”

Building trust

Much of the surrogate’s work revolves around her relationship with anxious parents-to-be. For Errera, that work started the moment she met the Smiths for the first time, at an Addison restaurant.

Errera’s easygoing personality and her practical way of explaining what would happen at every step put the Smiths at ease and helped set the tone for the pregnancy.

Kirsten Smith attended all of Errera’s appointments with her obstetrician, and the two women talked by phone or in person at least once a day. “I felt like I was very involved,” Smith said. “She would tell me how the baby was moving and everything. I wanted to know everything.”

The birth and afterward

Though nine months pregnant, Errera attended Smith’s baby shower at a Blue Mesa restaurant, and it was there she felt the first stirrings of labor. That night, Smith joined Errera at Texas Health Presbyterian Hospital Dallas. The next morning, Errera gave birth to a 7-pound, 9-ounce baby girl, with the Smiths in the delivery room.

“I was the first one to hold her,” said Kirsten Smith, who wore a hospital robe that allowed her to hold the infant next to her skin. She and her newborn, named Merrin, stayed with Errera overnight at the hospital.

There was never any question who the child’s mother was, Errera said.

“I know one of the big fears parents have is if the surrogate is starting to get attached to the baby, and is she going to be sad when it’s over,” she said. “It’s never even a thought in my mind.”

If there is sadness, it’s not because she misses the baby, Errera said.

“It’s because you miss that relationship you formed with the parents,” she said. “You go from constant contact to going back to your life and they go back to theirs. You miss that for a little while when it’s all over.”

Merrin Smith, 7, ran to catch up with her friends in her Girl Scouts group as they visited Frisco Square on Dec. 13, 2017.

(Nathan Hunsinger/Staff Photographer)

Merrin Smith climbs a tree while visiting Frisco Square with her Girl Scouts group in Frisco, Texas on Dec. 13, 2017.

(Nathan Hunsinger/Staff Photographer)

Kirsten Smith (left) talked to daughter Merrin while they got cupcakes at Fluellen Cupcakes in Frisco in mid-December.

(Nathan Hunsinger/Staff Photographer)

When the Smiths first looked into surrogacy, they weren’t sure they wanted a relationship with their surrogate after the birth, Kirsten Smith said. “You don’t know how you’re going to feel afterward. Is this person going to feel like they’re the real mother? Are they going to judge me on how I raise my child?”

As it turned out, that wasn’t an issue. “I’ve never felt uncomfortable around Jill, and when she’s here, I don’t feel like she’s judging me,” she said.

Merrin is now 7 years old, and Errera has been to every birthday party.

On Merrin’s last birthday in August, Errera was running late to the restaurant. When the waiter came by, Merrin told him to hold off a minute.

“You have to wait for Miss Jill,” Merrin said. “She carried me in her belly.”